Momentum is building for value of investment (VOI) with health management programs

Employees are more optimistic. The number of sick days are declining. Talented people are staying longer. When openings occur, resumes from choice candidates flood your inbox. And productivity is on the rise. Do you believe that your health and wellness program plays a role in these kinds of positive developments — in addition to reducing […]
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Make sure your ICD-10 physician training meets the mark

The ICD-10 compliance date is squarely within the sights of the health care industry. With less than four months to go until we cross the transition threshold, consider what you’ve done — and what you can still do — to help your doctors succeed as they move from ICD-9 to ICD-10. Help physicians document for […]
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King v. Burwell: How should payers move forward after the ruling?

With the U.S. Supreme Court handing down its decision today in the Affordable Care Act case King v. Burwell, health insurers can turn their full attention to preparing for their continued participation in the health insurance exchanges. Ruling to retain policies in accordance with the current PPACA law as written allows the tax subsidies to […]
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Changing reimbursement models requires changes to physician compensation models – the value of unblinded performance metrics

In my final blog related to changing reimbursement models requiring changes to physician compensation models, I want to identify the value of sharing unblinded information once physicians have approved, digested and absorbed the compensation model. Many of the organizations I have talked to find unblinded incentives to be a very powerful tool. However, you need […]
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Better predictive modeling requires bigger, more varied, higher quality data sets

In a previous blog about predictive analytics, we discussed how comprehensive health care data is necessary for a high degree of prediction. In this post, we’ll discuss the variables that increase predictive accuracy. The larger the better. As the sample size of a predictive model grows, the model’s uncertainty level and degree of bias decreases. […]
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HIPAA audits and investigations — they’re baaaack…

If you didn’t receive a HIPAA pre-audit questionnaire from the U.S. Department of Health and Human Services Office of Civil Rights (OCR) last summer, you likely breathed a heavy sigh of relief. But don’t rest easy just yet, as your audit reprieve could be short-lived. Approximately 400 audits are coming, and organizations selected to be […]
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A look back at AHIP Institute 2015

Participants from across Optum™ and more than 100 health plan organizations gathered in Nashville June 3–5 for the 2015 America’s Health Insurance Plans (AHIP) Institute. Recognized as the premier trade event for payer organizations, more than 4,000 attendees representing health plans and affiliated businesses attend AHIP annually. The event traditionally attracts mid-to-senior level executives, providing […]
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ICD-10: Have you planned for the aftershock?

Once again, the nation is bracing for the anticipated widespread tremors of the ICD-10 conversion. Assuming the mandate is enforced on October 1, 2015, hospitals are — or had better be — building out their support strategies. Whatever your tactics, don’t underestimate the aftershock. There’s no one-size-fits-all preparedness plan, but we do know one thing […]
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More than numbers: Converting data to better care

In caring for people with mental health and substance abuse disorders, a community hospital in California sought to help patients recover faster while minimizing inpatient re-admissions. Partnering with the Achievements in Clinical Excellence (ACE) team from Optum™ enabled the hospital to gain insights into how to manage costs and provide better care. Based on our […]
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Evaluating data’s impact on sepsis care

The previous post introduced Saint Thomas Health’s efforts to use data to reduce sepsis mortality within its patient population. This post will discuss some of the results of the organization’s efforts. Getting information into the hands of doctors and nurses treating potentially septic patients is key. As important is the collection and analysis of vast […]
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